TETANUS 4

IMMUNIZATION
A non-immunized individual (one who has not received Tetanus
Toxoid) requires passive immunization by intramuscular
administration of HUMAN HYPER-IMMUNE GLOBULIN containing 500
units of Tetanus antitoxin.

In addition,he receives the initial TETANUS TOXOID dose of 0.5
ml. Aluminium Phosphate, adsorbed Tetanus Toxoid intramuscularly.
This is followed by another injection of toxoid 4-6 weeks later.
Third injection can be given in 6-12 months.

TREATMENT
Treatment of established case consists of :
i) Immediate surgical care.Any wound suspected to be contaminated
with Clostrodium Tetani i.e.all street accidents need CLEANING
and
DEBRIDEMENT.
Wounds can be left OPEN till the patient has recovered from
convulsive
stage of the disease,if this stage has already manifested.

ii) Antibiotic therapy with PENICILLIN is effective against
vegetative cells of Clostridium tetani.

iii)Use of muscle relaxant and SEDATION with Barbiturates

iv) Maintenance of fluid-electrolyte and nutritional balance.

v)Where tetanus toxoid and human immunoglobulin have not been

given, horse serum ANTITOXIN should be given before surgery
in doses of 15,000 units to 50,000 units half intravenously
and half intramuscularly after skin test for sensitivity.

vi) Care of the respiratory tract (removal of secretions).

vii)Care of the bladder (catheter) and fecal impaction

viii)Nursing care in a quite dimly-lit room.

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